Journal of perinatology : official journal of the California Perinatal Association · 2020
Improving perinatal regionalization: 10 years of experience with an Arkansas initiative.
СтатьяНаблюдательное исследованиеПоддержка исследования: вне правительства СШАПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Bronstein Janet M, Ounpraseuth Songthip, Lowery Curtis L
Аннотация
OBJECTIVE: To examine the impact of Antenatal and Neonatal Guidelines, Education and Learning Systems (ANGELS) on neonatal intensive care unit (NICU) preterm delivery rates.
STUDY DESIGN: In this longitudinal observational study, linked vital records and Medicaid claims records for 29,124 preterm births (April 2001-December 2012) to Medicaid covered women were used to examine factors predicting whether deliveries occurred at hospitals with neonatology-staffed NICUs. The factors associated with delivery are estimated and compared for baseline and three post-implementation periods.
RESULTS: Rates for NICU preterm deliveries increased from 28 to 37% over the time period. Compared to baseline, adjusted NICU delivery rates in the middle and late implementation periods were statistically significant (p < 0.001). Negative impacts of long travel times were reduced, while impacts of obstetrician prenatal care changed from negative to positive association.
CONCLUSION: Findings validate the ANGELS initiative premise: academic specialists, working with community-based care providers, can improve perinatal regionalization.
STUDY DESIGN: In this longitudinal observational study, linked vital records and Medicaid claims records for 29,124 preterm births (April 2001-December 2012) to Medicaid covered women were used to examine factors predicting whether deliveries occurred at hospitals with neonatology-staffed NICUs. The factors associated with delivery are estimated and compared for baseline and three post-implementation periods.
RESULTS: Rates for NICU preterm deliveries increased from 28 to 37% over the time period. Compared to baseline, adjusted NICU delivery rates in the middle and late implementation periods were statistically significant (p < 0.001). Negative impacts of long travel times were reduced, while impacts of obstetrician prenatal care changed from negative to positive association.
CONCLUSION: Findings validate the ANGELS initiative premise: academic specialists, working with community-based care providers, can improve perinatal regionalization.